


Because Of You I Might Think Twice

by glamtrashbandito (custodian)



Category: Twenty One Pilots
Genre: Alternate Universe - Hospital, Implied/Referenced Suicide, M/M, Mental Health Issues, Residency Is Hell, Strangers to Lovers, Tacos Are A Love Language
Language: English
Status: Completed
Published: 2019-05-31
Updated: 2019-05-31
Packaged: 2020-03-30 22:04:19
Rating: Mature
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 4,144
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/19036486
Author URL: https://archiveofourown.org/users/custodian/pseuds/glamtrashbandito
Summary: Tyler might have survived medical school, but residency is the hardest thing he's ever done.  And then he finds an EMT crashed out in the on-call room, and everything gets a little weird.





	Because Of You I Might Think Twice

**Author's Note:**

> This is what happens when your friend sends you a link to [this loop](https://twitter.com/tylersloops/status/1129177265655488512), and the first thing out of your mouth is, "He looks like a fucking medical resident."

There's an EMT in the on-call room. 

Specifically, there's a fully-dressed EMT crashed out on the narrow bunk that takes up three quarters of the windowless, glorified closet set aside for the floor’s on-call staff. It’s dingy, it’s cold, and it’s the most beautiful oasis in Tyler’s whole world because it his quiet room, where he can eke out scraps of peace between rounds and pagers and endless paperwork.

Or it would be, except there’s a strange guy in here who shouldn’t even be in this part of the hospital, crashed out taking the strategic nap that Tyler has been dying for all night.

The guy didn’t even take off his boots.

And so Tyler, who is twenty hours into his shift, and sixty hours into an 80 hour week, and only holding it together because he hasn’t had a chance to slow down at all between cans of Red Bull, does the only reasonable thing: he slumps back against the door, slides into a crouch with his head in his hands, and breaks out into hysterical giggles.

He’s not really a swearing man, but fuck his life. Just...fuck it. Fuck his life.

It takes a second to register how fast Bed Guy stops being Bed Guy. It’s like one second he’s snoring and the next he’s knelt down on the floor with Tyler, wide-eyed, and offering a hurried series of apologies in that even-handed hospital voice that he probably uses to tell people things are fine when their legs are on the other side of the highway. 

Tyler stares at him in a vain effort to process dark eyes and messy blue hair and tattoos. He stammers out a weak stream of gibberish in a reedy, far-away sounding voice. 

Also, his breathing is all messed up. Like, clinically.

"Tyler, right?” the guy says, pointing at the name tag on Tyler’s white coat. He’s making some of the most solid eye contact Tyler’s ever experienced in his life. “I’m Josh." 

"Josh."

"Yep, Josh. Where are you from, man?"

Tyler sucks in a breath. “Columbus.” 

“Seriously? Me too.” He’s got this warm, easy smile going on. He makes breathing look easy. Long, slow breaths. “How long you been out here?”

“Two years.” No. Tyler shakes his head that’s not quite right. He takes a breath. “Year and a half. Residency.”

“Cool. What program?” 

“Internal medicine.” 

“So you’re, like, halfway through. Nice. You gonna do a fellowship after?”

He nods. “Looking at it, yeah.” 

“Good stuff.” Josh puts a hand on his arm, fingers curling around his wrist. “Hey, Tyler? Can you take a nice deep breath with me?” 

He does. Sort of.

“Awesome. How about another one?” 

He does, and this time Josh gives him a huge grin. It’s nice. Crinkly in the right parts of his face, you know? Warm. They sit like that for a while, just breathing together. After a little while something starts to unspool in Tyler’s brain. His shoulders loosen. He settles down onto the floor next to the door. 

“You gonna be alright?” 

“Yeah,” Tyler says, nodding. “Yeah, I’m good.” 

“Cool.” Josh reaches into his jacket. He pulls out a Red Bull and a couple of Larabars, and presses them into Tyler’s hands before he stands up. He reaches down and squeezes Tyler’s shoulder. “See you around, man. Get some rest.” 

And then he’s gone. 

Tyler opens one of the Larabars. God, he’s starving. 

Two bites in it clicks: he’s just had a tidy little panic attack in front of a stranger, who just walked him through it like it was nothing, all while keeping an eye on his vitals. And then the dude gave him snacks.

It’s kind of awe inspiring, actually.

He still doesn’t know how the guy got in here in the first place.

# # # 

Also, he doesn’t see Josh around.

It makes sense. Tyler’s impossible schedule is never going to match up with anyone else’s, least of all somebody else who works EMS hours. They do, what, 24 a couple of days a week? Sixteen for three? Plus, the hospital’s pretty big. And the ER is on the other side of the building. They might as well live on different planets. 

Irrationally, he’s starting to wonder if he imagined the whole thing just to feel better. 

“Imagined” is a more benign term than “hallucinated.” Fact is, he’s got no life or time for thinking about anything other than medicine. He still barely knows anyone out here. He’s living out of a studio apartment, which he barely sees, his diet is ridiculous, and it goes without saying that depression is at least as comorbid with medical residency as it is with medical school. And that’s for people who aren’t even prone to it in the first place. Which he is. Intensely. 

There is a non-zero chance that Josh-with-the-Red-Bull-and-the-snacks does not exist.

Hallucination or not, Josh-with-the-Red-Bull-and-the-snacks is like a song Tyler can’t get out of his head. Like he keeps trying to hum the guy’s face in his spare moments. As mysteries go, it’s so compelling that he’s tempted to lean into the crazy. After all, is it so wrong to have an imaginary friend during postgrad if it keeps him alive?

He tries it a little. Just a little. Imagines Josh is around when he feels like everything in his skull is starting to dissolve. It feels good. Dangerous, but good. He feels a little less alone. He has one-sided conversations in the on-call room. In the car. In the dark at night when he’s lucky enough to be home. 

And then -- on what is either day nine or twelve depending on if you’re reckoning by calendars or number of sleeps -- Josh sits down next to him in the cafeteria with a tray full of tacos.

“Hey,” Josh says.

Tyler freezes. The adrenaline hit makes his mouth and his solar plexus and his hands and the soles of his feet feel weird. He wonders if he should report to the fourth floor for a 72 hour observation.

“You okay, man?” 

“Yeah,” Tyler lies, then looks down at the tray. “That’s a lot of tacos.” 

“I know, right?” He grins, then shoves about half a taco into his mouth. He’s mostly done chewing when he pauses, swallows, and looks back at Tyler. “Hold up, you like tacos, right?”

“Uh, yeah?” 

“Cool.” Josh slides the tray between them. “Go nuts.”

“Solid choice of words,” he says under his breath, grabbing a taco. Josh doesn’t seem to notice. They eat in silence for a little while, side by side, while staff and patients’ families kind of drift around them. “So, do you just, like, not have anything better to do than feed stray residents?”

“What do you mean?”

“This is the second time you’ve been like, ‘here, eat this.’ You don’t even know me.”

“So let’s hang out.”

Tyler sputters out a laugh. “Um, what?” 

“Look,” Josh says, suddenly earnest. “If I’m out of line, tell me, but you’ve got this vibe, like you’re stressed out, and--” 

“I’m in residency, dude. Everyone in residency is stressed out.” 

“That’s not what I meant.”

“So what did you mean?” 

“I don’t know,” Josh says. “But we should hang. I miss Columbus. We can, like, miss it together or something.”

It catches him off guard. Not just because both times they’ve met have been deeply weird -- to say nothing of the whole Imaginary Josh thing, which they will not be discussing -- but because it’s exactly what Tyler wants. He’s not used to getting what he wants. Honestly, it kind of freaks him out. 

And then his pager goes off.

The nice thing about not having time to think is that sometimes that makes it easier to do. Tyler digs in his pocket for one of his cards -- the ones his residency program issued him to give to patients when he’s attending -- and scrawls his actual not-work cell on it.

“Text me,” he says, shoving it into Josh’s front jacket pocket, and giving him a quick slap on the shoulder as he darts past. 

# # # 

Three things Tyler learns about Josh Dun via the medium of text messages: 

**Josh Dun is a freak who actually likes coffee.**

>> It’s dirt water.

<< It’s awesome dirt water. It makes me strong.

>> It makes you weird.

<< Your face is weird.

**Josh Dun skateboards to work.**

<< Oh hey I almost just got hit by a car on the way in today.

>> Holy crap, are you okay?

<< It’s cool. Plus, if I get hit, work comes to me.

**Josh Dun can (and will) sleep anywhere.**

>> Hey, you awake?

>> Wait, nevermind. Found you. 

>> Seriously, how do you keep getting into the on-call room up here? ER’s on the other side of the building.

>> I should probably stop texting you now.

# # # 

But back to the depression thing.

Some nights, Tyler spends his shift uncomfortably aware of where the sharps are. Or the fire escapes. Or the way up to the roof. The bridge on the highway. The relationship between his gas pedal, his steering wheel, and trees on the side of the road.

Tonight is one of them. 

The on-call room is empty. He pulls off his white coat, hangs it on the hook on the back of the door, sets an alarm on his phone. He lays down on his back on the cot. He’s more tired than he’s ever been in his life, and he hurts. 

His pager feels like a bomb strapped to his body.

There was a kid his freshman year, all the way back in his undergrad, who lived on his floor until he killed himself jumping off of the balcony. They didn’t really know each other, but for the rest of the year, Tyler had to walk past where he landed. 

Almost nobody saw the body. Tyler didn’t. But knowing that campus facilities could erase death so swiftly and completely that the only sign was blank, pristine concrete haunted him.

At first, it seemed like it haunted everyone else, too. People avoided that side of the building. They whispered about it. Everybody knew about the thing that nobody could see. 

But then people forgot, or quit acknowledging it, or whatever. 

Tyler didn’t forget. For the rest of the year that spot pulled at him like a magnet. He’d walk along the edge of it, feet only barely avoiding the edges of that one, specific slab of concrete. It was like stepping on it would break some secret bond between himself and a dead stranger. Or worse, maybe it would be contagious. Like whatever resolve led to that final leap could be transmitted to him.

What would happen if he could get in the car, make the drive, and do it again? To just sit there in the presence, whatever it is? Would it help him stay alive?

He doesn’t know. 

So he hides in the dark, eyes squinched shut, wishing he could sleep.

# # # 

“Hey, when’s your day off this week?” 

“Uh.” It takes Tyler a minute, because he has to remember which day he had off last week. And sure, he could just get his phone out, but his burrito is kind of coming apart, and he needs all the hands he can get. “Uh. Thursday?” 

“Want to come over?” 

“Dude, you would not believe the pile of laundry I’ve got happening.” 

“Oh.” Josh’s own burrito is already gone. He’s moved on to what’s left of the nachos. Hospital cafeteria Mexican or not, food is food. “Rephrasing that: do you want to come over and do laundry?”

Tyler balks. “You want me to bring my laundry over?”

“Is that weird?” 

“It’s a little weird.” 

“Yeah, but it’s free. We can get pizza and watch Netflix or something.”

“I feel like I should make a Netflix-and-chill joke here.”

“I mean, obviously there’s gonna be chill,” Josh says, before dropping his voice half an octave and mock-purring: “ _So much chill._ ” 

“Freak,” Tyler says, laughing through a mouthful of burrito. 

# # # 

Thing is, even on his bad days, he’s not actually bad at his job. 

The paperwork is the worst, because it’s just him and the computer, but give Tyler anything to do with people and he can just focus on that. He can see the shape of an interaction and fit himself into that shape, disappearing into the labor of medicine.

Which is why not really knowing people at work is a good thing. His supervisors can be impressed with him, and his patients can get what they need, and he can work with the rest of the team, and it’s good. He goes through the motions, and the motions are objectively good motions. 

He does not want to mess with the stability of the motions.

They’re on Josh’s couch, playing Smash Bros on an old GameCube -- Tyler as Shiek and Josh as Captian Falcon -- when out of nowhere, Josh asks, “Hey, you doing okay?” 

Tyler stares hard at the screen. He punches buttons furiously on his controller while he tries not to think about how far away his body feels all of a sudden. Lack of acknowledgement is a wall that keeps him safe, and he doesn’t know what he did that Josh could see over or under through it. 

“Ty?”

“You really want to know?” 

“Yeah.” On screen, Prince Shiek sends Captain Falcon zooming offscreen to his pixelated doom. Josh puts his controller down with a shocking amount of equanimity for a dude who’s just had his ass kicked. “What’s going on?” 

Tyler blinks. “Wait, seriously?” 

“Yeah, seriously.” 

So here’s a thing: Josh Dun is a motion Tyler wants desperately to keep going through. Even though he’s really not great at any emotion that isn’t pain or desperation right now, it’s like the deep nerves of him can feel the pressure of where something good could be, and opening this box? He can’t. But there’s not a right answer to this question and...well, honestly it pisses him off. 

“You’re not my shrink, dude.”

Josh sits back a little against the arm of the couch. “So that’s a no?” 

“What do you think?” he snaps. And then he thinks better of it, takes a breath, and rubs his face. “Look, this is really not a great time.”

“Okay.” 

“Because if I start, I’m scared I won’t stop.”

“Okay.” 

“And I just--” He takes a breath. “It doesn’t stop. None of it stops, and it’s like every time I start to break through the haze I get dragged back down. And I try to keep going, but it’s all inertia now. Pretty soon the wheels are going to come off, and the whole car’s gonna just disintegrate around me, and --” 

“Which metaphor are we chasing here?” 

“You’re seriously critiquing my metaphors right now?” He laughs, in spite of himself, even though he’s shaking. He pulls his knees up to his chest. “My whole brain just wants to throw up right now.” 

“That’s a hell of an image.” 

“It’s a pretty good reason to stay away,” Tyler says, eyes drifting to a spot where Josh isn’t. He feels sick. He’s fucked this up. He fucks everything up, and all he can do is sit in this silence and wait for everything to come apart.

“You know I get puked on at least three times a week, right?” 

Tyler shakes his head, trying to clear it. “What?” 

“Just saying,” Josh says with a shrug. “I’m not going to minimize what you’ve got going on, because it sounds like a lot, but give me some credit, man. And I know I’m not your shrink. I just care and stuff.” 

The silence between them is about the noisiest silence ever -- the GameCube’s still playing the same musical loop over and over -- but Tyler sits on his side of it, in the space Josh has made for him, utterly clueless on what to do with it.

So he picks up his controller. “You, uh. You still want to play?” 

“Yeah,” Josh says, getting his own. “I’ll even let you kick my ass.” 

“I was already kicking your ass.”

“Whatever. Come at me.” 

# # # 

They make a deal: Tyler is the only one allowed to start The Conversation.

The Conversation is Specifically Not To Occur At Work, because if it does, Tyler has to stop being Doctor Joseph (who is probably going to do a year as Head Resident instead of going straight into a fellowship because he’s extremely good at his job) and start being Tyler again.

Doctor Joseph can jump in when the intern in the ER rotation screws up by putting a patient who’s allergic to sulfa drugs on the wrong kind of IV antibiotics. Doctor Joseph can cope when a patient with ulcers is throwing up blood and having trouble managing chronic pain because he can’t take the pills he’s used to. 

Tyler has hands that shake when he freaks out and a brain that locks up so bad that microwaving food or doing laundry or filling in his calendar can’t happen all at once without him collapsing into himself.

“Okay,” Josh says. “But we have to shake on it.”

“Um.” Tyler tilts his head and, after an awkward pause, tentatively holds out his hand. “Yeah, alright.”

“No, I mean with, like, a handshake,” Josh says, turning to face him. “You ever make up a handshake when you were a kid?” 

“Like with slaps and--” he gestures with his hands a little vaguely.

Josh lights up. “Yeah.” 

“No.” 

“Me neither.”

And that’s how it starts, because Doctor Joseph is doing ER rotation for a while, and Josh Dun EMT-2, is absolutely going to see him when they work at the same time, and that first encounter in the hallway on a shift absolutely cannot involve The Conversation, but absolutely must involve an interaction, and it starts with four slaps, two bumps, grip-grip, etc.

The Handshake isn’t just The Defense Against The Conversation. It’s bigger than that. It makes Tyler’s heart want to explode, even on those days when he knows Josh can see what’s going on behind his eyes. It’s like it carves a space out in the universe that’s safe, where he can be broken, but not alone. He can trust Josh not to push until he’s ready. 

It’s the best thing that’s ever happened to him.

And then, one night, they get a jumper.

# # # 

Here are some fun facts about vertical deceleration injuries.

Falling is fine. Terminal velocity won’t hurt you. Human bodies don’t just pass out because they’re going as fast as they can. Landing, on the other hand? Landing is bad. When you land, your body hits like it weighs hundreds of pounds more than it does when you’re still. That means blunt force injuries. Fractures. Hemorrhage. Your bones shatter, and send shards through the soft parts of your body like shrapnel. Your organs rip free in your body cavity because inertia is merciless.

Tyler has read the papers. They give him nightmares about college.

He’s not a surgeon, but he’s involved in the immediate response of keeping this kid alive while the right people who are going to see this through all the way as fully fledged and qualified professionals assemble.

There’s no time for The Handshake when Josh’s ambulance shows up with this kid. Just a grave look in his dark eyes, and a plea. 

_Just keep this kid alive._

You’d better believe that Doctor Joseph holds it down, because Doctor Joseph Will Be Starting His Third Year Of Residency In July, and he is damn good at his job, even if he knows absently that this case is going to be the subject of dozens of grand rounds in the next six months, and that knowledge makes him want to drive to that square of concrete he’s been careful never to touch, curl up on it, and weep.

It takes forever. It goes so fast.

Afterward, he goes to get a cup of coffee, which he has no intention of drinking, but he needs to hold something and be still and be quiet in a place where he can breathe.

Maybe Josh is in the break room the whole time. Maybe Tyler notices the moment Josh walks in. It’s hard to tell. But when he does, it’s clear that this moment is The Conversation, and he doesn’t even have to speak. Josh just bundles him up in his arms, all Tyler wants is for him to tonight is stay.

# # # 

“Move over.” 

Tyler grumbles, but scoots just enough for Josh to curl up with him on the bunk in the ER’s (slightly more palatial) on-call room. 

“How do you keep getting in here?” he murmurs into the pillow. 

“I was a bad kid. Draw your own conclusions.”

They’ve started doing this, since the jumper. Mostly at Josh’s place -- Tyler hasn’t even seen his own apartment this week -- but if Josh pulls a double on a night that Tyler’s on overnights, there’s a 50/50 chance it’ll happen here, too. Someone somewhere is probably going to notice eventually. 

Someone somewhere can mind their own business. 

Behind him, Josh’s breath is warm and even. Tyler shifts a little, kind of adjusts so they fit together better. He drifts back into the half-sleep he does when he’s got the pager. 

“Hey.”

“Mm.”

“We’re friends, right?”

“Yeah?” Tyler nods, dimly aware of a weird feeling in his stomach and chest. “Why?” 

“So, uh. Is this weird?”

Tyler shifts onto his back, peers up into the dark. “I mean, maybe? Why, do you feel like it’s weird?”

“No.” 

“But you think it should feel weird?” 

“I think maybe I’m supposed to, yeah.” Josh’s hand is warm as it finds his. Their fingers lace together easily enough. “Which is stupid. And kinda makes me want to punch something.” 

Tyler laughs. “Dude, what would you even punch?” 

“I don’t know! Something soft, probably. Can’t do my my job as fast in a cast.”

“Dumbass.” Tyler drags him in closer. “Go to sleep.” 

# # # 

And the thing is, none of this fixes him.

Honestly, maybe nothing will fix him. Church never did, and neither did school, and while he’s (finally) seeing a therapist again when he can and taking something to take the edges of things off, Tyler still hurts a lot of the time. He’s probably always going to hurt. 

But he tries. He likes being good at things, and finds pleasure in his work, and gets angry when people and things in his life make it hard to do that. Sometimes it’s still hard to stay alive, but other times it’s just so good to feel the sun on his face and breathe the air and be who he is in the world. 

He falls down all the time. But he tries. 

Maybe the difference is that Josh is there to pick him up now. They’re making each other better people, because when one of them does something awesome -- like Josh working on his Paramedic cert -- you’d better believe the other one is there to help make it happen. And they have each other’s backs, like that night Tyler got decked by a belligerent drunk and Josh wound up handling it because night security was new and couldn’t deescalate a situation out of a paper bag.

They’re sitting on top of the table on the patio at Chipotle, enjoying a rare shared night off, when Josh looks over and says, “Hey, you want to move in?” 

“Did I not do that three months ago?” Tyler asks, only half joking.

Josh snorts and flicks a piece of lettuce at him.

“Seriously?” 

“Yeah. I mean, I’d have to break down the office so you could have a room, but--” 

“Whoa, hold on.” Tyler says, kind of on the edge of a weird panic he’s not naming just yet. “Don’t we both kind of use that office?”

Josh “Um, yeah?”

“So don’t break it down, man. We’ll just, you know.” He kind of shrugs a shoulder and sips his limeade. “Keep it weird, I guess.” 

Josh bites his lip, smiles. “How weird?” 

“I don’t know. Pretty weird, probably.” He gives Josh a sideways look. Scoots a little closer. Leans in. 

Josh’s lips are soft, and warm, and meet his easily. Like they’ve been doing this for ages. Years. Forever. And okay, there’s a moment when Josh turns for a better angle, and they kind of bump faces and teeth, but that’s not, like, a problem. That’s just them, figuring out how they fit and making it work until it occurs to both of them that they’re sitting on top of a picnic table and people in the parking lot are kind of starting to stare. 

“Let’s go home,” Tyler says, grabbing Josh’s hand. 

He might be shaking a little. His breath might be a little messed up. Like, clinically. And it’s everything he ever wanted.


End file.
